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Adult Novice and Under 18 Supervised Roped Climbing & Bouldering

Adult Novice and Under 18 Supervised Roped Climbing & Bouldering

The following information will be used to complete a document that you will then read and sign. Please complete the following form to create this document.

If the participant is under 18 and you are not the parent or legal guardian of the child, you MUST get the parent or legal guardian to complete the Parental Consent form prior to your visit. 

Only Climbing Hut Shrewsbury registered climbers can supervise Novice climbers according to thier proficiency level. One Climbing Hut Shrewsbury registered climber is only allowed to supervise two novices or under 18's at any one time. ​


Novice Climbers

Novice climbers are just that! They are not permitted to climb or boulder in the centre without the supervision of a registered climber.

As the supervising climber you should be capable and willing to provide full instruction for the novice in the following basic techniques: safe use of the bouldering wall, correct use of a climbing harness, correct attachment of climbing rope to climbing harness, correct belaying technique and any other climbing techniques required to ensure their safety and the safety of others around them.

IF YOU DO NOT FEEL ABLE TO PROVIDE SUCH SUPERVISION THEN YOU SHOULD NOT COMPLETE THIS FORM.

 

ABC Participation Statement

"All climbing and bouldering activities have a risk of serious injury or death. Participants must be aware of and accept that even if they follow all good practice there may still be the risk of accident and injury. It is the responsibility of the participant to adhere to the conditions of use." 

It is important that you understand this document. There is inherent risk involved with climbing centres and associated activities. By signing this form, you are stating you understand that these risks cannot be completely removed. If you do not understand any of the terminology or content, ask a member of staff to clarify. 

 

As the supervising adult you agree that you answer the questions listed below to prove your competancy. 

Supervising Adult Signature


First Novice's Name

First Name*

Middle Name

Last Name*
First Novice's Date of Birth*
First Novice's Signature*
Second Novice's Name

First Name*

Middle Name

Last Name*
Second Novice's Date of Birth*
Third Novice's Name

First Name*

Middle Name

Last Name*
Third Novice's Date of Birth*
Fourth Novice's Name

First Name*

Middle Name

Last Name*
Fourth Novice's Date of Birth*
Fifth Novice's Name

First Name*

Middle Name

Last Name*
Fifth Novice's Date of Birth*
Sixth Novice's Name

First Name*

Middle Name

Last Name*
Sixth Novice's Date of Birth*
Seventh Novice's Name

First Name*

Middle Name

Last Name*
Seventh Novice's Date of Birth*
Eighth Novice's Name

First Name*

Middle Name

Last Name*
Eighth Novice's Date of Birth*
Ninth Novice's Name

First Name*

Middle Name

Last Name*
Ninth Novice's Date of Birth*
Tenth Novice's Name

First Name*

Middle Name

Last Name*
Tenth Novice's Date of Birth*
Novice's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Supervising Adult Email Address

Email*

Confirm Email*
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Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Data Protection

Privacy and General Data Protection Regulations (GDPR) Policy

To comply with GDPR we are required to obtain your consent to collect and store your personal data. Climbing Hut Shrewsbury Ltd. is the Data Controller. We require your data to ensure that you comply with the conditions of use of the Centre. We will store your data securely and will not disclose it to any third party. At any time, you can request a copy of your data free of charge. GDPR makes provision for you to request to have your data removed and erased. This is known as the 'Right to erasure/ right to be forgotten'. When data is held for the establishment, exercise or defense of legal claims we have the right to refuse to erase the data. For this reason, our insurers insist that we continue to hold your data for 3 years from the date of your most recent visit.

In the case of Under 18 years olds, this is extended to 3 years beyond their 18th birthday. If you make a written request for erasure of your data, this request will be logged and the data will be erased after the period stated above.

In order to be allowed to use the facilities and services provided by Climbing Hut Shrewsbury you are required to consent to our Privacy and GDPR Policy. 


I consent to the Climbing Hut Shrewsbury Privacy and GDPR Policy.*
To be completed by competent supervising person

Supervising Person Details



Supervising Persons First Name *

Supervising Persons Last Name

Supervising Persons Date of Birth *

Supervising Persons Address



Street *

Town *

Post Code *

Relationship to Novice climber *

Conditions of Registration to be completed by Supervising Person

You must answer the following questions by ticking YES or NO. 


Having read the above ABC participation statement and the terms and conditions of Climbing Hut Shrewsbury, do you consent to supervising the above named participant climbing at Climbing Hut Shrewsbury and will you ensure that the participant understands that any instructions given by staff must be adhered to at all times?*
Are you over 18 years of age?*
#Are you able and willing to explain safe bouldering practices as specified in the Climbing Hut Shrewsbury terms and conditions and as per your induction?*
#Are you able and willing to assist your Novice in the correct use of a climbing harness?*
#Are you able and willing to assist your Novice in tying into their harness using a re-threaded figure-eight with double stopper knot?*
Do you require instruction in any of the above techniques (marked #)*
If your Novice climber belays, as the supervising member will you PHYSICALLY hold the brake rope at all times?*
Do you understand that equipment is available for hire but that it is your responsibility to determine what equipment your Novice needs?*
Do you agree to ensure that your Novice adheres to the terms and conditions and rules of the centre?*
Do you agree to be responsible for the safety and behaviour of your Novice during their visit?*
Do you agree to abide by the Rules of the climbing centre?*
I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS*
The supervising adult must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Supervising Adult Name

First Name*

Middle Name

Last Name*

Phone*
Supervising Adult Date of Birth*
Supervising Adult Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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